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Moore J, Renn T, Veeh C. The metropolitan context of substance use and substance use disorders among US adults on probation or parole supervision. Subst Abus 2021; 43:161-170. [PMID: 33848449 DOI: 10.1080/08897077.2021.1903651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Rates of substance use and substance use disorders are higher among adults on probation or parole supervision compared to the general population. Substance use is a risk factor of not adhering to supervision requirements, which may result in revocation and incarceration. Examining associations of metropolitan area status with substance use and substance use disorders may identify specific substance use behaviors that can be targeted in community corrections prevention and treatment services. The present study examined associations of metropolitan area residency with substance use and substance use disorders among adults on probation or parole supervision. Methods: Data came from the 2015 to 2018 National Survey on Drug Use and Health ([NSDUH]; N = 4266 adults on parole or probation). Multivariable logistic regression was run for substance-specific models for each of the two outcomes of past-year use and substance use disorder. Results: Nonmetropolitan residency was associated with higher odds of methamphetamine use and lower odds of cocaine use. Nonmetropolitan residency was associated with higher odds of methamphetamine use disorder and lower odds of opioid use disorder and cocaine use disorder. Conclusions: Study findings highlight the differences of substance use and substance use disorders between levels of metropolitan areas for those on probation or parole. Findings suggest that cocaine use should be emphasized in clinical services in large metropolitan areas, whereas methamphetamine use may be prioritized in nonmetropolitan areas. Further study is needed to investigate the interface of substance use behaviors and community corrections outcomes across metropolitan and nonmetropolitan areas.
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Affiliation(s)
- John Moore
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Tanya Renn
- College of Social Work, Florida State University, Tallahassee, FL, USA
| | - Christopher Veeh
- School of Social Work, The University of Iowa, Iowa City, IA, USA
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Davis A, Pala AN, Gilbert L, Marotta PL, Goddard-Eckrich D, El-Bassel N. Using actor-partner interdependence modeling to understand recent illicit opioid use and injection drug use among men in community supervision and their female partners in New York City. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 83:102843. [PMID: 32653669 PMCID: PMC7669699 DOI: 10.1016/j.drugpo.2020.102843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 04/15/2020] [Accepted: 06/29/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The United States' opioid crisis disproportionately affects individuals in the criminal justice system. Intimate partners can be a source of social support that helps reduce substance use, or they can serve as a driver of continued or increased substance use. Better understanding of the association between intimate partner characteristics and illicit opioid use and injection drug use among individuals in community supervision could be vital to developing targeted interventions. METHODS Using actor-partner interdependence models, we examined individual and partner characteristics associated with recent illicit opioid use and injection drug use among males in community supervision settings in New York City (n = 229) and their female partners (n = 229). RESULTS Higher levels of depression (aOR 1.98, 95% CI [1.39-2.82], p ≤ 0.01) and anxiety (aOR 1.98, 95% CI [1.42-2.75], p ≤ 0.01) were associated with recent opioid use among males in community supervision. Females with a partner having higher levels of anxiety were more likely to have recently used opioids (aOR 1.52, 95% CI [1.06-2.16], p ≤ 0.05). Males with a female partner with higher levels of anxiety (aOR 2.16, 95% CI [1.31-3.56], p ≤ 0.01) or depression (aOR 1.70, 95% CI [1.01-2.86], p ≤ 0.05) were more likely to recently inject drugs. Women with a male partner who had been in prison were more likely to have recently injected drugs (aOR 3.71, 95% CI [1.14-12.12], p ≤ 0.05), but women who had a male partner who had been arrested in the past three months were less likely to have recently injected (aOR 0.08, 95% CI [0.02-0.46], p ≤ 0.01). CONCLUSIONS Results suggest that recent individual illicit opioid use and injection drug use is associated not only with individual-level factors, but also with partner factors, highlighting the need for couple-based approaches to address the opioid epidemic.
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Affiliation(s)
- Alissa Davis
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA.
| | - Andrea Norcini Pala
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Louisa Gilbert
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Phillip L Marotta
- Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT, 06511, USA
| | - Dawn Goddard-Eckrich
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Nabila El-Bassel
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
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El-Bassel N, Davis A, Mandavia A, Goddard-Eckrich D, Hunt T, Marotta P, Chang M, Wu E, Gilbert L. Men in Community Correction Programs and Their Female Primary Sex Partners: Latent Class Analysis to Identify the Relationship of Clusters of Drug Use and Sexual Behaviors and HIV Risks. J Urban Health 2019; 96:411-428. [PMID: 29948784 PMCID: PMC6565788 DOI: 10.1007/s11524-018-0265-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Existing research indicates that justice-involved individuals use a variety of different drugs and polysubstance use is common. Research shows that different typologies of drug users, such as polydrug users versus users of a single drug, have differing types of individual-, structural-, and neighborhood-level risk characteristics. However, little research has been conducted on how different typologies of drug use are associated with HIV risks among individuals in community corrections and their intimate sex partners. This paper examines the different types of drug use typologies among men in community correction programs and their female primary sex partners. We used latent class analysis to identify typologies of drug use among men in community correction programs in New York City and among their female primary sex partners. We also examined the associations between drug use typologies with sexual and drug use behaviors that increase the risk of HIV acquisition. The final analysis included a total of 1167 participants (822 male participants and 345 of their female primary sex partners). Latent class analyses identified three identical typologies of drug use for both men and their female primary sex partners: (1) polydrug use, (2) mild polydrug users with severe alcohol and marijuana use, and (3) alcohol and marijuana users. Men and women who were classified as polydrug users and mild polydrug users, compared to those who were classified as alcohol and marijuana users, tended to be older and non-Hispanic Caucasians. Polydrug users and mild polydrug users were also more likely to have risky sex partners and higher rates of criminal justice involvement. There is a need to provide HIV and drug use treatment and linkage to service and care for men in community correction programs, especially polydrug users. Community correction programs could be the venue to provide better access by reaching out to this high HIV risk key population with increased rates of drug use and multiple sex partners.
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Affiliation(s)
- Nabila El-Bassel
- Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA.
| | - Alissa Davis
- Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
- HIV Center for Clinical and Behavioral Studies, Columbia University, New York, NY, USA
| | - Amar Mandavia
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Dawn Goddard-Eckrich
- Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
| | - Timothy Hunt
- Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
| | - Phillip Marotta
- Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
| | - Mingway Chang
- Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
| | - Elwin Wu
- Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
| | - Louisa Gilbert
- Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA
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Diehl A, Clemente J, Pillon SC, Santana PRH, da Silva CJ, Mari JDJ. Early childhood maltreatment experience and later sexual behavior in Brazilian adults undergoing treatment for substance dependence. ACTA ACUST UNITED AC 2018; 41:199-207. [PMID: 30540023 PMCID: PMC6794126 DOI: 10.1590/1516-4446-2017-0020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 06/28/2018] [Indexed: 11/30/2022]
Abstract
Objective: To investigate the prevalence of early childhood maltreatment and associations with later sexual behavior among adult substance users. Methods: A cross-sectional study enrolled 134 substance dependents who sought outpatient care in São Paulo, Brazil. Childhood trauma prevalence was assessed using the Childhood Trauma Questionnaire (CTQ). The Sexual Addiction Screening Test (SAST), drug of choice (DOC), and sexual behavior were also investigated. Results: The sample was composed predominantly of single adult males (76.1%), with alcohol as the DOC (73.9%). Experiences of emotional neglect (88.1%), emotional abuse (80.6%), physical neglect (78.4%), physical abuse (64.2%), and sexual abuse (31.3%) were prevalent. Women were more likely to have been sexually abused (OR 2.9, 95%CI 1.15-7.61) and physically abused (OR 3.7, 95%CI 1.31-10.6) in childhood. Those who were sexually abused in adulthood were more likely to have suffered physical abuse in childhood (OR 6.9, 95%CI 1.45-11.8). The odds of having been sexually abused in childhood were higher among subjects who reported to have exchanged sexual favors for drugs (OR 5.7, 95%CI 1.35-9.64) and to have been sexually abused in adulthood (OR 6.1, 95%CI 5.2-12.36). Conclusion: Physical and sexual abuse in childhood are highly prevalent in substance-dependent adults, and are associated with sexual revictimization and high-risk sexual behavior in adulthood.
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Affiliation(s)
- Alessandra Diehl
- Departamento de Psiquiatria,Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Jales Clemente
- Departamento de Psiquiatria,Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Sandra C Pillon
- Departamento de Enfermagem Psiquiátrica e Ciências Humanas, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da Organização Pan-Americana de Saúde (OPAS)/Organização Mundial da Saúde (OMS) para o Desenvolvimento da Pesquisa em Enfermagem, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | | | - Claudio J da Silva
- Departamento de Psiquiatria,Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Jair de J Mari
- Departamento de Psiquiatria,Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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Clark CB, Swails JA, Akao KA, Pontinen HM, Cropsey KL. Gaging the impact of multiple substance use on community corrections involvement. Addict Behav 2018; 81:55-59. [PMID: 29428813 PMCID: PMC5845843 DOI: 10.1016/j.addbeh.2018.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 02/01/2018] [Accepted: 02/02/2018] [Indexed: 01/31/2023]
Abstract
Historically, research has demonstrated that multiple substance use, compared to single substance use, poses additional challenges for treatment throughout the continuum of care including referrals, interventions, and relapse prevention. However, it appears that this pattern cannot be easily generalized to all criminal justice settings as evidenced by mixed findings across criminal justice samples. The purpose of the current study is to investigate possible differences in legal and substance-related outcomes between multiple substance users and single substance users within a community corrections sample. Structured clinical interviews were conducted to divide 531 individuals under community corrections supervision into three groups including multiple substance users, single substance users, and non-substance users. Results indicated that while multiple substance users were arrested more frequently and had more problems with family members, there were no differences compared to their single substance using counterparts in terms of depressive disorders, anxiety disorders, or types of offense. These findings contrast with previous research on samples outside of community corrections suggesting that multiple substance use requires tailored interventions with consideration to context of their use. Discussion includes limitations to generalizability and assessment of substance use as well as implications for treatment and future research.
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Affiliation(s)
- C Brendan Clark
- Wichita State University, Department of Psychology, United States.
| | - Jeffrey A Swails
- Wichita State University, Department of Psychology, United States
| | - Karen A Akao
- Wichita State University, Department of Psychology, United States
| | - Heidi M Pontinen
- Wichita State University, Department of Psychology, United States
| | - Karen L Cropsey
- University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, United States
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Diehl A, Pillon SC, Santos MAD, Laranjeira R. Abortion and sex-related conditions in substance-dependent Brazilian patients. CAD SAUDE PUBLICA 2017; 33:e00143416. [PMID: 29166482 DOI: 10.1590/0102-311x00143416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 02/06/2017] [Indexed: 01/27/2023] Open
Abstract
Abortion is a very sensitive issue with relevance to public health; however few clinical or population-based studies have examined induced abortion among drug users. The study aims to evaluate the prevalence of induced abortion and sex-related conditions in an inpatient drug user sample. A cross-sectional design study was conducted in an inpatient addiction treatment unit in São Paulo, Brazil, with a sample of 616 patients, aged 18-75. Sociodemographic data, sexual behavior, and dependence severity were evaluated in relation to induced abortion. Approximately 27% of patients reported having a history of abortion (themselves in the case of women or partners in the case of men). The mean age was 34.6±10.9 years old, 34.9% diagnosed with severe alcohol dependence, 33% were diagnosed with severe levels of dependence on other drugs, 69.6% were diagnosed cocaine users (inhaled and smoked), and alcohol was the drug of choice for 30.4%. Chances of having a history of abortion is greater for women than for men with a odds ratio (OR = 2.9; 95%CI: 1.75-4.76), (OR = 1.7; 95%CI: 1.09-2.75) of no condom use; (OR = 2.0; 95%CI: 1.35-3.23) of history of STI and (OR = 3.2; 95%CI: 1.29-5.73) use of morning-after pill. Drug- and alcohol-dependent patients have high-risk behaviours of sporadic use or no-condom use which contribute to unplanned pregnancy and induced abortion, making this vulnerable population a group which deserves special attention in sexual health prevention programmes and health promotion efforts for the reduction of induced abortion.
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Affiliation(s)
- Alessandra Diehl
- Unidade de Pesquisa em Álcool e Drogas, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Sandra Cristina Pillon
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Manoel Antonio Dos Santos
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brasil
| | - Ronaldo Laranjeira
- Unidade de Pesquisa em Álcool e Drogas, Universidade Federal de São Paulo, São Paulo, Brasil
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7
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Clemente J, Diehl A, Santana PROH, da Silva CJ, Pillon SC, Mari JDJ. Erectile Dysfunction Symptoms in Polydrug Dependents Seeking Treatment. Subst Use Misuse 2017; 52:1565-1574. [PMID: 28471320 DOI: 10.1080/10826084.2017.1290114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess erectile dysfunction (ED) symptom prevalence, sexual behavior conditions, and risk factors associated to ED in a male polydrug dependent sample. METHODS A cross-sectional design study was conducted with 102 substance-dependent male polydrug users who sought outpatient treatment in São Paulo, Brazil. Sociodemographic data, drug of choice, chronic disease questions, sexually transmitted infections, International Index of Erectile Function (IIEF) scale, Sexual Addiction Screening Test (SAST), and WHOQOL-Bref instrument were used. RESULTS The erectile dysfunction prevalence was 32.3% and it was related to the marital status (single) (p < 0.001), occupational status (fully unemployed) (p < 0.001), presenting a chronic disease (p = 0.027), and with types of sexual partnerships (occasional partner) (p < 0.001). Alcohol (73.5%), tobacco (79.4%), cannabis (83.3%), and cocaine (snorted 78.4% and smoked 42.2%) were the drugs of choice. The ED risk decreased when marital status was married (odds ratio = 3.2 CI95% 1.411-7.518) and with chronic disease (odds ratio 0.06 CI95% 0.00-0.97), while having occasional sexual partners increased 14 times ED risk (OR 14.0 CI95%1.62-122.18). There were no significant associations between quality of life, DOC and ED. CONCLUSION Approximately one third of the substance dependents in this sample presented ED. There is a need to integrate psychiatric and clinical care in substance treatment services, and to improve the provision of sexual health care and support available for this population.
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Affiliation(s)
- Jales Clemente
- a Psychiatric Department , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Alessandra Diehl
- a Psychiatric Department , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | | | | | - Sandra Cristina Pillon
- c Psychiatric Nursing and Human Science Department , University of Sao Paulo at Ribeirao Preto College of Nursing , Ribeirão Preto , Brazil
| | - Jair de Jesus Mari
- a Psychiatric Department , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
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Paraphilic Thoughts, Behaviors and Sex Addiction in a Sample of Persons Who Use Drugs: A Cross-Sectional Study. J Addict Med 2017; 11:377-385. [PMID: 28727662 DOI: 10.1097/adm.0000000000000337] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the prevalence of paraphilic thoughts/behaviors (including paraphilic disorders) with and without sexual addiction and sexual-related conditions in a sample of substance disorder patients. METHODS This was a cross-sectional study of substance-dependent individuals who sought outpatient treatment in São Paulo, Brazil. Data included sociodemographic information, drug of choice, responses to questions about sexual behavior, and to the following standardized questionnaires: (a) Sexual Addiction Screening Test, and (b) Childhood Trauma Questionnaire. RESULTS The sample comprised 134 persons who use drug, predominantly men (76.1%), 39.6% were aged between 18 and 29 years, and 54.9% were single. Most were persons who use polydrug, 73.9% were alcohol and cocaine users, 63.4% marijuana users, 81.1% tobacco users, and 5.2% steroid users. Prevalence of paraphilic thoughts/behaviors (including paraphilic disorders) with and without sexual addiction was 47%. The HPV/herpes and hepatitis B rates were 7.9% (P = 0.021) and 6.3% (P = 0.046) respectively. Paraphilic and nonparaphilic thoughts/behaviors were associated to the presence of childhood physical neglect (odds ratios [OR] = 4.7, 95% confidence interval [CI] 1.0 to 21.9), low educational level (OR = 7.2, 95% CI 1.4 to 36), heterosexuality (OR = 3.8, 95% CI 1.1 to 12.8) and youth (age 18 to 20 years) (OR = 5.6, 95% CI 1.4 to 11.8). CONCLUSIONS The high prevalence of paraphilic thoughts/behaviors with or without sex addiction in persons who use drugs may be related to the experience of physical and emotional neglect during childhood and this possibility should routinely be investigated in clinical practice.
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The Mediating Role of Autonomy and Relatedness on Maternal and Child Outcomes. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 46:209-221. [PMID: 28474188 DOI: 10.1007/s10802-017-0303-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The current study examined the mediating role of both mother and child interactive behaviors, which granted or undermined autonomy and relatedness, on the bidirectional and longitudinal association between maternal depressive symptoms and child internalizing behaviors, as well as the association between maternal substance use and child externalizing behaviors. Child's sex and mother's drug of choice were explored as potential moderators of the mediation relationship. Data were collected from 183 dyads including treatment-seeking substance using mothers and their children (95 males, aged between 8 and 16 years old). Structural equation modeling analysis showed girls' internalizing and externalizing behaviors at the 3-month follow-up were negatively associated with the same behaviors at the 12-month follow-up through increased relatedness undermining behaviors from their mothers at the 6-month follow-up. Among mothers with opioids as their drug of choice (DOC), children's externalizing behaviors at the 3-month follow-up were positively associated with mothers' substance use at the 12-month follow-up through the elevated levels of mothers' relatedness undermining behaviors at the 6-month follow-up. Among mothers with alcohol as their DOC, maternal depressive symptoms at the 3-month follow-up were positively related to children's internalizing behaviors at the 12-month follow-up through reduced relatedness undermining behaviors exhibited by mothers at the 6-month follow-up. To our knowledge, this is one of the first studies to attempt to unravel these longitudinal and bidirectional influences as well as the moderated mediation pathways among families with a substance using mothers.
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Diehl A, Pillon SC, dos Santos MA, Rassool GH, Laranjeira R. Criminality and Sexual Behaviours in Substance Dependents Seeking Treatment. J Psychoactive Drugs 2016; 48:124-34. [DOI: 10.1080/02791072.2016.1168534] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Diehl A, Rassool GH, dos Santos MA, Pillon SC, Laranjeira R. Assessment of Sexual Dysfunction Symptoms in Female Drug Users: Standardized vs. Unstandardized Methods. Subst Use Misuse 2016; 51:419-26. [PMID: 26894525 DOI: 10.3109/10826084.2015.1110175] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
AIMS The aim of this study is to evaluate whether there is a difference in the identified prevalence between the assessment of symptoms of sexual dysfunction in female drug users using a standardized scale and by means of a nonstandardized set of questions about sexual dysfunctions. METHOD A cross-sectional study was conducted with two groups of substance-dependent women using the Drug Abuse Screening Test, the Short Alcohol Dependence Data questionnaire, the Fagerström Test for Nicotine Dependence for the evaluation of the severity of dependence, and the Arizona Sexual Experience Scale. FINDINGS In both groups, the severity of dependence and the prevalence of symptoms of sexual dysfunctions in women were similar. CONCLUSION The use of standardized and nonstandardized instruments to assess sexual dysfunction symptoms is an essential resource for the provision of good-quality care to this clientele.
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Affiliation(s)
- Alessandra Diehl
- a Federal University of São Paulo, National Institute of Alcohol and Drugs Policy , São Paulo , Brazil
| | | | - Manoel Antônio dos Santos
- c Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo , Ribeirão Preto , Brazil
| | - Sandra Cristina Pillon
- d Faculty of Nursing at Ribeirão Preto, University of São Paulo , Ribeirão Preto , Brazil
| | - Ronaldo Laranjeira
- a Federal University of São Paulo, National Institute of Alcohol and Drugs Policy , São Paulo , Brazil
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Shmulewitz D, Greene ER, Hasin D. Commonalities and Differences Across Substance Use Disorders: Phenomenological and Epidemiological Aspects. Alcohol Clin Exp Res 2015; 39:1878-900. [PMID: 26332166 DOI: 10.1111/acer.12838] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 07/07/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND Although psychoactive substances vary in many ways, they have important commonalties, particularly in their ability to lead to an addiction syndrome. The field lacks an updated review of the commonalities and differences in the phenomenology of alcohol, cannabis, tobacco, stimulants, opioids, hallucinogens, sedatives/tranquilizers, and inhalants and their related substance use disorders (SUDs). METHODS DSM-IV and DSM-5 SUD diagnostic criteria were reviewed, as was evidence from recent epidemiological and clinical research: psychometric studies (test-retest reliability, latent trait analysis); physiological indicators (tolerance, withdrawal); prevalence and age of onset. Information was incorporated from previous reviews, PubMed and Scopus literature searches, and data from large U.S. national surveys. RESULTS Empirical evidence in the form of test-retest reliability and unidimensionality supports use of the same DSM-IV dependence or DSM-5 SUD diagnostic criteria across substances. For most substances, the criteria sets were generally most informative in general population samples at moderate-to-severe levels of SUD. Across substances, 2 criteria (tolerance and use in hazardous situations) were identified as functioning differently in population subgroups. Since substances have different pharmacological effects, withdrawal is assessed using substance-specific symptoms, while tolerance is not; issues remain with the assessment of tolerance. Alcohol, tobacco, and cannabis were consistently identified as the substances with earliest onset of use, highest prevalence of lifetime use, and highest prevalence of lifetime disorder. CONCLUSIONS Despite differences between psychoactive substances, the generic DSM criteria set appears equally applicable across substances. Additional studies of tolerance and hazardous use will be useful for future nosologies. Alcohol, cannabis, and tobacco are the substances with the greatest public health impact due to the high prevalence and early onset of their use, and the potential all 3 substances have to lead to addiction.
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Affiliation(s)
- Dvora Shmulewitz
- Department of Psychiatry, Columbia University, New York City, New York.,New York State Psychiatric Institute, New York City, New York
| | - Emily R Greene
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York
| | - Deborah Hasin
- Department of Psychiatry, Columbia University, New York City, New York.,New York State Psychiatric Institute, New York City, New York.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York
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DeLisi M, Angton A, Behnken MP, Kusow AM. Do adolescent drug users fare the worst? Onset type, juvenile delinquency, and criminal careers. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2015; 59:180-195. [PMID: 24071557 DOI: 10.1177/0306624x13505426] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Although substance abuse often accompanies delinquency and other forms of antisocial behavior, there is less scholarly agreement about the timing of substance use vis-à-vis an individual's antisocial trajectory. Similarly, although there is extraordinary evidence that onset is inversely related to the severity of the criminal career, there is surprisingly little research on the offense type of onset or the type of antisocial behavior that was displayed when an individual initiated his or her offending career. Drawing on data from a sample of serious adult criminal offenders (N = 500), the current study examined 12 forms of juvenile delinquency (murder, rape, robbery, aggravated assault, burglary, larceny, auto theft, arson, weapons, sexual offense, drug sales, and drug use) in addition to age at arrest onset, age, sex, race to explore their association with chronicity (total arrests), extreme chronicity (1 SD above the mean which was equivalent to 90 career arrests), and lambda (offending per year). The only onset offense type that was significantly associated with all criminal career outcomes was juvenile drug use. Additional research on the offense type of delinquent onset is needed to understand launching points of serious antisocial careers.
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Cropsey KL, Leventhal AM, Stevens EN, Trent LR, Clark CB, Lahti AC, Hendricks PS. Expectancies for the effectiveness of different tobacco interventions account for racial and gender differences in motivation to quit and abstinence self-efficacy. Nicotine Tob Res 2014; 16:1174-82. [PMID: 24719492 PMCID: PMC4184395 DOI: 10.1093/ntr/ntu048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 03/02/2014] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Racial and gender disparities for smoking cessation might be accounted for by differences in expectancies for tobacco interventions, but few studies have investigated such differences or their relationships with motivation to quit and abstinence self-efficacy. METHODS In this cross-sectional study, 673 smokers (African American: n = 443, 65.8%; women: n = 222, 33.0%) under criminal justice supervision who enrolled in a clinical smoking cessation trial in which all received bupropion and half received counseling. All participants completed pretreatment measures of expectancies for different tobacco interventions, motivation to quit, and abstinence self-efficacy. The indirect effects of race and gender on motivation to quit and abstinence self-efficacy through expectancies for different tobacco interventions were evaluated. RESULTS African Americans' stronger expectancies that behavioral interventions would be effective accounted for their greater motivation to quit and abstinence self-efficacy. Women's stronger expectancies for the effectiveness of pharmacotherapy accounted for their greater motivation to quit, whereas their stronger expectancies for the effectiveness of behavioral treatments accounted for their greater abstinence self-efficacy. CONCLUSIONS Findings point to the mediating role of expectancies for treatment effectiveness and suggest the importance of exploring expectancies among African Americans and women as a way to augment motivation and self-efficacy.
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Affiliation(s)
- Karen L Cropsey
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL;
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Erin N Stevens
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL
| | - Lindsay R Trent
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL
| | - C Brendan Clark
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL
| | - Adrienne C Lahti
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL
| | - Peter S Hendricks
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL
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Factors associated with rapid failure in a Treatment Alternatives for Safer Communities (TASC) program. J Subst Abuse Treat 2013; 45:376-80. [DOI: 10.1016/j.jsat.2013.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 05/13/2013] [Accepted: 05/21/2013] [Indexed: 11/21/2022]
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16
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Levola J, Kaskela T, Holopainen A, Sabariego C, Tourunen J, Cieza A, Pitkänen T. Psychosocial difficulties in alcohol dependence: a systematic review of activity limitations and participation restrictions. Disabil Rehabil 2013; 36:1227-39. [DOI: 10.3109/09638288.2013.837104] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Diehl A, Silva RLD, Laranjeira R. Female sexual dysfunction in patients with substance-related disorders. Clinics (Sao Paulo) 2013; 68:205-12. [PMID: 23525317 PMCID: PMC3584261 DOI: 10.6061/clinics/2013(02)oa14] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 10/26/2012] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To estimate the prevalence of female sexual dysfunction symptoms and the associated risk factors in a sample of patients with substance-related disorders admitted to a specialized in-patient care unit. METHODS This study used a cross-section design, with eight months of data collection, conducted with substance-dependent women using structured questionnaires to collect socio-demographic data and identify their drug of choice. The Drug Abuse Screening Test, Short Alcohol Dependence Data questionnaire, Fagerstrom Test for Nicotine Dependence, and Arizona Sexual Experience Scale were also administered. RESULTS The sample consisted of 105 women who had a mean age of 34.8 years (SD = 12.1, range = 18-65) and were predominantly heterosexual (74.3%), single (47.6%), Caucasian (50.5%), catholic (36.2%), and educated only to the level of primary education (40%), with a monthly family income of up to one minimum salary (37.5%). In 42.9% of the patients, crack was the drug of choice; 47.6% of the sample qualified for the Drug Abuse Screening Test (substantial problems related to drugs), 43.8% exhibited Short Alcohol Dependence Data (moderate or severe dependency), 47.6% exhibited Fagerstrom Test for Nicotine Dependence (high or very high nicotine dependence). The prevalence of sexual dysfunction symptoms was 34.2% (95% CI = [25.3, 44.1]), and a high level of nicotine dependence and low income increased the chances of having sexual dysfunction by 2.72-fold and 2.54 fold, respectively. An association was also observed between female sexual dysfunction symptoms and schooling and levels of drug dependence. CONCLUSIONS Female sexual dysfunction symptoms were common among this sample and primarily associated with high levels of nicotine use.
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Affiliation(s)
- Alessandra Diehl
- National Institute of Alcohol and Drugs Policy, Alcohol and Drug Research Unit, Psychiatry Department, Federal University of São Paulo, Sao Paulo, SP, Brazil.
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